Syncope is a symptom that presents with a transient loss of consciousness. Causes can be broken down, most commonly into neurocardiogenic or vasovagal, cardiac, and orthostatic. Neurological causes of loss of consciousness, such as seizure, can present similarly to syncope. Syncope can also occur in extreme environments, as a side effect of medication or hypoglycemia. The differential is broad. Getting details on the sequence of events including observer account if possible is key to determining how best to proceed with respect to need for further evaluation vs supportive care. We describe four cases of students presenting with syncope, and discuss etiology, clinical assessment, disposition and red flags requiring transfer to a higher level of care. A review of Postural Orthostatic Tachycardia (POTS) deserves mention as students with this condition can present with syncope.